title: The marriage of clinical trials and clinical decision science.
abstract: Clinical decision science is concerned with rational clinical decisions. All branches of medical research contribute here, but controlled clinical trials of the pragmatic variety carry a particular responsibility. Usually, however, they are not conducted and reported so that they can be used directly as input to a decision analysis. We suggest that the forces of the two methodologies should be united, and point out some areas where this 'marriage' will have a non-trivial impact: choice of end points, style of outcome recording, adaptive designs, and style of result presentation. Special attention is given to the decision-analytic setting of research priorities, the role of utility calculus in quantifying the ethical dilemmas that surround clinical trials, and the use of patient attitude towards outcomes of treatment as a covariate in its own right.
authors.affiliation: Institute of Medical Genetics (Biostatistics), University of Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Hilden
authors.forename: J D
authors.initials: JD
authors.lastname: Habbema
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic / Q000379:methods*; D003661:Decision Support Techniques; D004992:Ethics, Medical; D012107:Research Design